Critical paper for the film Whatever Works by woody Allen Essay

Critical paper for the film Whatever Works by woody Allen - Essay Example His most reoccurring theme in this movie is hard and painful life experienced by many Americans. He further manages to bring out the uncertainty of life. Through these issues, we as humans can reflect on our lives and learn to appreciate our time on earth due to the inevitability of death. His work provides an insight into the philosophy of life to the current and future generation. Like Boris, the present and future generations will realize that harsh realities of life and sufferings impact them enormously, as well as their works. With proper planning and wise decisions, people can easily evade misfortunes and lead better lives, not like the one led by Boris. What I find interesting is that Boris continually insults people, but despite this, people still love him. He does this in a humorous, innovative, and creative way. He adopts impressive and witty lines to inform the people of their foolishness and stupidity in the movie. It is evident when he is accused of hitting a young child with a chessboard, but he defends himself by stating, â€Å"I did not hit with it, I picked it up and dumped the piece on his head as an object lesson, to shake him out of his vegetable torpor†. It is interesting to learn that Boris does not come across as sour and unpleasant to the people he always insults. Majority of the people like and appreciate him since he is uniformly funny especially when delivering his insults. However, Allen appears to be provocative in his movie. I find the scenes in his film depicting majority of Americans as conservative and sexually repressed provocative. To him, any American citizen outside New York is ignorant and unenlightened on the current lifestyle. In addition, he says that they are homosexuals who do not find opposite sex attractive, but would rather make love to sheep. This movie provokes the rest of Americans. It creates bad blood between the rest of America and New York. Such words can cause

Differences in Competencies between ADN vs. BSN Essay Example for Free

Differences in Competencies between ADN vs. BSN Essay According to the society of Human Resources Management, competency means the knowledge and skills required to perform a job, which all contributes a positive outcome. Even though the competency among ADN and BSN are almost similar, there are slight variations based on the departments where the nurse work, such as management level of care and neonatal department. Good start of an introduction. Consider a topic sentence here that states: this paper will describe†¦Ã¢â‚¬ ¦.. An Associate Degree Nurse is one who completed the 2 year program or 3 year diploma this is not true, these 2 are different course by a school of nursing, community, or junior college. They demonstrate competencies in various aspect of patient care. ADNs are competent to perform assessment by collection of patient’s health history, including past medical and surgical history. They perform the physical assessment by gathering information, such as height and weight, vital signs, and head to foot assessment, including all body system. They are also competent to perform cognitive, psychosocial, spiritual, and functional level assessment. After assessing the patient, they find out the nursing diagnosis using their knowledge, skills, and experience. The ADN analyzes the patient’s condition using their age, cultural diversity, and risk factor. He/she then formulates and plans the care by prioritizing the patient’s need based on Maslow’s hierarchy needs, in which patient’s safety is the first importance. They formulate the plan of care by critical thinking, reflection, and problem solving skills. Before they implement the treatment regimen, they let the patient make health care choices by providing accurate and reliable information. The ADN are competent to delegate the patient care to other authorized health care personnel by giving relevant instructions and supervisions. They implement the treatment within his/her accepted professional nursing practice in a different clinical setting. They also make sure to give teaching about the treatment, which includes the effects and side effects of drugs and expected outcome. These all help the patient to alleviate their anxiety about the health status. Finally, they evaluate the outcome and effectiveness by reassessing and continuous monitoring. Moreover, ADNs provide physical competencies like gross and motor skills, strength, and mobility by moving and positioning the patient by using proper body mechanism. Their sensory perception provides a safe environment. They are competent in life saving practices, such as cardiac monitoring and airway management. They provide patient care by giving I.V, oral medications, blood transfusions and wound care. They demonstrate care and respectful behavior towards the patient, family, and other co-workers. Need to reference data within the text Bachelor of Science Degree in Nursing is a 4 year bachelor program accredited by a college or university. A BSN has the same medicalbedside nursing skills of an ADN. He/she provides the same patient care by assessment, diagnosis, planning, implementation, and evaluation. They also have physical competencies and sensory perception. Apart from that, they do their clinical judgment by using their critical and analytic thinking, which they earned through researches and evidence based practices. They have sufficient emotional stability to be responsible and accountable during a highly stressful event. They know how to deal with unexpected and changing environment. They show interpersonal skills and communication skills by interacting positively with patient, family, and large communities both in verbal and written form. Their logical and analytic thinking in patient management will help them to acquire higher education. Moreover, they creatively respond to continuously changing health system. Good review of BSN competencies. Again, need to reference within the text. An ADN acquired knowledge and skills from years of experience in clinical practice. They work with patients in a relatively short time. However, a BSN has knowledge and skills based on their researches, evidence based practice, leadership, and management. Their skills help them to provide a better patient care in a short time period. For an ADN, the nursing is a job and have little commitment to the work. Without considering the long term results, they move from one job to another. However, BSN is a career, which is a life time dedication that requires development and on-going learning. They can function at high intellectual levels and carry a strong professional identity and follow code of ethics. They are more accountable, independent, and responsible. Nursing care and approaches to decision-making are different based upon the educational preparations. For example, we had a 50 year old patient in our floor that came with left hip fracture. The patient underwent an open reduction and internal fixation of left hip. After 4 hours of post anesthesia care, the patient came to the floor. The ADN, who is the primary care nurse, assesses the patient and carried out all post-op orders. The patient was drowsy and was on morphine PCA. After 2 hours, the patient suddenly woke-up with pain in the left hip. The ADN gave more pain medicine and monitored the respiratory status. All of a sudden patient complained of shortness of breath. The nurse found the patient’s oxygen saturation dropped to 82 percent. She stopped the PCA pump and put the patient on 2 liters of oxygen yet the patient was complaining about severe pain in her hip. Apparently, the patient continued to complained of chest pain and her oxygen level continued the same. The RN called the charge nurse, who is a BSN. She assessed the patient and went through the patient history. Suddenly, she called the rapid response team; meanwhile, she ordered a stat chest x-ray by thinking that patient had a pulmonary embolism and transferred the patient to ICU. Later, we came to know the patient had pulmonary embolism. In this situation, the RN gave the basic treatments according to the knowledge from her experience. On the other hand, the BSN treated the patient from her critical thinking and high level of knowledge, which saved the patient’s life. Good patient care scenario The ADN can handle the critical patient situation very minimally by using her basic knowledge, skills, and experience with the help of other person. However, the BSN can handle the same situation independently with his/her critical thinking. Different level nurses have different roles in a hospital, even though they have same preliminary education about providing forthe patient care. The job expectations, patient interactions and contact are different in perspective of the RN’s and BSN’s duty. Good conclusion . . References Catalano, J.T. (2003).Nursing now: Today’s issues, tomorrow’s trends. Philadelphia: F.A. Davis. Need to put title into italics Competencies and Performance Standards Essential for Nursing Practice.( 2011) St Louis University. Retrieved from http://www.slu.edu/x19905.xml Hollis, Forster, RN (2011) ADN vs. BSN Retrieved from need to include date of retrieval http://nursinglink.monster.com/education/articles/3842-adn-vs-bsn

The Power of Working Out Essay -- Exercise Self Image Papers

The Power of Working Out Wherever I go, whenever I go, whoever I see, I am always astonished by the way that people want to present themselves. The principle of working out reminds me of nothing else but a song titled â€Å" wherever, whenever, whoever â€Å" by Shakira. It is for the pure sense that everyone wants to look good and become popular by looking good. The media brings about popularity just by looking this so called â€Å" good. â€Å" Take for example Britney Spears, Christina Aguilara, Shakira, and other teen pop sensations. Many of these pop stars are not even old enough to drink, however they are making millions of dollars from their performances and cd’s that have sold. But it is not just the music that has created such popularity for them. It is without any doubt their appearance just as well. This ethnography will produce the answers to the many asked questions to reasons people even start working out, the multi effects of working out, and to produce the different outlooks of working out by different people. It is the purpose to produce a culture of working out from a masculine and feminine perspective. My research is based on where I work in the weight room located in the building of the JCC located in West Bloomfield, Michigan. It is a very big building perhaps the size of a large high school which is surrounded by a great amount of parking spaces. Inside the JCC there are different facilities. It has a Basketball court, a hall for doing big parties, a rink for roller hockey and the weight room that I am doing. People that are members of this JCC are able to use the weight room anytime they want as well as use the sauna, steam room, they have the luxury of having towels be provided for them a... ... I don’t try to impress the opposite sex as much as I used to. Although it is still nice to have people look at you while your working out I feel that staying fit and healthy is just as important as looking good. â€Å" With the help of my field notes, Keneth Pike’s explanations within etic and emic perspectives, and the interviews I did within these perspectives I was able to realize the true power of working out. The true reasoning that all people are different. Whether some are doing it to stay in shape or to look better, all are doing it for some soul purpose. America is all about working hard and striving to achieve. It is a place of freedom and opportunity. The weight room is an opportunity for people to look better, feel better, as well as socialize with other people. Works Cited: Pike Kenneth. â€Å" A Stereoscopic Window on The World, â€Å"

Broken Eggs Essay

The young girl’s body is slumped upon an elevated surface, while her head is tilted to the left at a forty-degree angle. She is draped in a sheer, white blouse and apron, covering a yellow corset and light blue dress. A periwinkle scarf on her head keeps her blonde hair pulled away from her face, revealing her luminescent skin – lit up magnificently by the thin stream of light making its way through the window to her right – and innocent features. The girl’s expression seems to be of pure grief, as she looks down towards the egg basket on the floor; it’s as if she has lost something very dear. This young girl is perhaps saddened at the fact that the egg basket has dropped to the ground and the eggs are now broken. However, the other subject matter in the painting alludes to a larger scale of loss. Immediately above the girl’s left shoulder, a man – appearing about equal in age – stands with his body swaying to his right. His rig ht hip is pointed in the direction of the far left corner of the room, while his head is tilted forty degrees to the right, in the opposite direction of the young girl’s. One could draw a line straight down the middle of the painting and see that there is symmetry between the young girl’s, and man’s, head. The egg basket is centered in between them, creating a focus on la scà ¨ne du crime; a sun hat with a girlish ribbon around it lies delicately next to the basket, where countless white eggs lay broken, spewing yellow yolk. As one zeroes in on this fragment of the painting, it is important to take note of its specific mise en scà ¨ne. In other words, the placing of the small sun hat next to the basket allows the artist to better tell a story of innocence, and imaginably the shattered eggs define the loss of that purity. It is essential to mention the style and structure of the painting before going any further with the subject matter. The brushstrokes when conveying the foreground of the painting are smooth and seamless. However, on the wall in the background the strokes appear harsh and horizontal, creating a rough texture in contrast with the character’s skin and clothes. The brown color scheme of the background is uniform throughout, in accordance with the light coming into the very small and dingy room. There is a picnic table behind the young girl and its scale accurately contributes to the probable size of the room. The ceiling is high which suggests that the scene takes place in the servant’s quarters of a wealthy estate.

Combination Therapy in Heart Failure

The ability of the heart to pump blood Is impaired and It can no longer meet the bodys metabolic requirements Table 1 . New York Heart Association Classiflcation of Heart Failure. Remme W], Swedberg K. Guidelines for the diagnosis and treatment of chronic heart failure. European Heart Journal. [Online] 2001; 22(17): 1527-1 560. during the rest or exercisel. By treating HF we try to relieve patients symptoms, Improve their quality of life, prevent hospitalization and most importantly prolong their life. The treatment Includes Improved diet (reduced salt intake), physical activity and pharmacological treatment.There are numerous angiotensin-receptor blockers (ARBs), vasodilators, angiotensin-converting enzyme (ACE) inhibitors Ramipril) and beta-blockers (Carvedilol). We will have a look at the last two classes. They have been PATHOPHYSIOLOGY The previous hemodynamic model was not adequate and was therefore replaced by neurohormonal model, which involves Reninangiotensin-aldosterone-sys tem sympathetic nervous system 1 , (RAAS) 3 is summarized in Figure 1. The activation of RAAS leads to vasoconstriction, oedema and myocardial fibrosis, which are induced by Angiotensin Ill . roven to be very efficient in HF by numerous clinical studies2-4. SYMPTOMS AND SIGNS HF involves many symptoms such as dyspnoea fatigue, and ankle oedema. l The signs of HF are achycardia (>100 beats per minute), tachyarrhythmia, tachypnoea, distended Jugular murmur and S3 and S4 heart sounds. The Figure 1 . pathophysiology of heart failure and different levels of therapeutic intervention. Taken from: Perrenoud J]. Heart failure (Part 1). European Geriatric Medicine. [Online] 2011; 2(3): 159-171. ccurrence of these symptoms and signs depends on One of the earliest neurohormonal changes in HF is the severity of heart failure and whether it is caused sympathetic activation and it has a primary role in vein, peripheral oedema, hepatomegaly, heart by systolic dysfunction or diastolic dysfunction . isease progression. Left ventricular remodeling, cell death and changes in gene expression are believed to be the main mechanisms that induce ejection fraction8-11. Because it is very potent, small myocardial doses of the tablet should be taken at the start of damage nervous stimulation 10. treatment (3. 125mg) twice daily.The dose is Heart failure can be categorized in predominantly gradually increased up to maximum of 50mg twice systolic dysfunction where the emptying of the left daily8. ventricle is not optimal and predominantly diastolic dysfunction where the filling of the left ventricle is Molecular targets ot optimall -6. As mentioned above, its major molecular targets are membrane receptors (?l, ?2 and 01). It acts on ion TREATMENT channels (Ca2+ and K+) as well. Carvedilol inhibits As mentioned above, the disease can be treated cardiac voltage-dependent potassium IKr channels using several different drug classes4.Multidrug with high potency, voltage-dependent calcium therap y is widely used in patients with heart failure. channels as well as Ca2+-permeable transient receptor potential (TRP) family channels in Failure Zealand cardiomyocytes and in vascular smooth muscle Carvedilol Trial) have been conducted to test the ells. Furthermore, a study conducted by (Kikuta et benefits of different combinations of drugs. It was al. , 2006) suggests that the drug blocks ATP- proven that these therapies significantly reduce the sensitive (KATP) and G-protein-activated (KG) risk of mortality and improve the symptoms. otassium However, hyperinsulinemia and hypoglycemia. It is believed implementing multi drug therapy. ACE inhibitors that the KG channel is opened by G protein in can cause hypotension, cough, and worsen the renal response to stimulation of G-protein-coupled function. Cough can cause patient noncompliance, uscarinic acetylcholine receptors in atria and sino- which in turn may result in the need of different drug therapy. Beta-blockers can cause bradyca rdia, channel would result in anti-cholinergic effects in hypotension, fatigue and fluid retention.Also, in the heartl 2. Study patients there with Australian-New are risks diabetes, associated beta-blockers channels. This results in could Pharmacodynamics Carvedilol is a racemic mixture of R and S Carvedilol enantiomers. Both enantiomers show al receptor Carvedilol is a non-selective beta-blocker (?l and inhibition. However, only S enantiomer inhibits ? ?2) has drenoreceptors. It competitively blocks both ?l and vasodilatation and antioxidant effects. Previously it ?2 receptors. The drug reduces high blood pressure be mainly due to the al and ? blockage.The inhibition contraindicated in HF as it has negative ionotropic of al receptor lowers total peripheral vascular effect. However, studies have shown that carvedilol resistance. Hence, it reduces afterload and balances in combination with ACE inhibitors improves the negative ionotropic effect the ? inhibition. As a function of the heart, especially left ventricular result, the stroke volume and cardiac output are al-blocker. elieved that Furthermore, carvedilol it should maintained or even increased. The systemic arterial The effects of carvedilol are summarized in figure pressure is lowered without reducing the renal 3. lood flow13-14. The antioxidant effects carvedilol and some of its metabolites are due to the presence of carbazole moiety (shown in Figure 2). In myocardial cell membrane carvedilol inhibits lipid peroxidation. Moreover, endothelial, vascular and neuronal smooth muscle cells from reactive oxygen species. Metabolite SB209995 is much more potent antioxidant than carvedilol itself. Animal studies have shown (Feuerstein et l. , 1998) heart failure imbalances the production of reactive oxygen species and the oxidant defense mechanism. The consequence is an excess of free radicals.This may result in cytotoxic effects as well as cardiovascular remodelingl 3. Figure 3. Molecular targets, pharmacodyn amics and clinical implications of carvedilol. Cheng J, Kamiya K, Kodama l. Carvedilol: Molecular and Cellular Basis for its Multifaceted Therapeutic Potential. cardiovascular Drug Revvtevs. coniine] 2006; 19(2): 152-71. Therapeutic efficacy Many different controlled clinical studies were made in order to determine the efficacy of carvedilol. The most known are COPERNICUS, CAPRICORN and USCHFS. They have all shown significant reduction in morbidity and mortality in comparison placebol 5-16.COMET investigating the difference between carvedilol and metoprolol efficacy. The study showed that the allcause mortality was lower with carvedilol (34%) Figure 2. Chemical structure of carvedilol (with postulated active sites) and its active metabolites. * denotes the point of assymetry. Taken from: Cheng J, Kamiya K, Kodama l. Carvedilol: Molecular and Cellular Basis for its Multifaceted Therapeutic Potential. cardiovascular Drug Rewtevs. coniine] 2006; 19(2): 152-71. Carvedilol aids lipid met abolism as it prevents the oxidation of low-density lipoproteins (LDL).It is known that LDL has destructive effects endothelial cells. Carvedilol also inhibits the Renin-angiotensin system (RAS). Hence, the production of Angiotensin II is lowered. Furthermore, studies on cardiac rat myocytes showed that carvedilol enhances the production of nitrite. It is therefore believed that it can increase the NO synthesis through some adrenoreceptor independent mechanism. However, the role of excessive amounts of NO in the diseased heart remains unclear 13-14. than with metoprolol (40%) as shown in figure 417. Figure 4.All-cause Mortality between Carvedilol and Metoprolol. Poole-Wilson PA, Swedberg K, Cleland JGF et al. Comparison of carvedilol and metoprolol on clinical outcomes in patients with chronic heart failure in the Carvedilol or Metoprolol European Trial (COMET): randomized controlled tnal.